Br J Cancer: Based on the classification of albumin bilirubin (ALBI) to evaluate the efficacy and safety of cabozantinib in the treatment of advanced hepatocellular carcinoma (HCC)

Hepatocellular carcinoma (HCC) patients are often accompanied by liver cirrhosis, and its severity is generally assessed by Child-Pugh classification
.

Most clinical trials for systemic treatment of HCC are limited to Child-Pugh A patients, including the Phase 3 CELESTIAL trial of cabozantinib in HCC

Hepatocellular carcinoma (HCC) patients are often accompanied by liver cirrhosis, and its severity is generally assessed by Child-Pugh classification

The patients were randomly divided into two groups 2:1, the cabozantinib group (60 mg orally per day) or placebo
.

To assess the clinical outcome of patients in the CELESTIAL study with ALBI grade 1 or 2 at baseline

The patients were randomly divided into two groups 2:1, the cabozantinib group (60 mg orally per day) or placebo

Among 707 patients, they were randomized 2:1 to receive cabozantinib (60 mg per day) or placebo.

In ALBI level 1 patients, cabozantinib improved the median OS of patients compared with placebo by 17.

OS

OS

Among ALBI grade 1 patients, cabozantinib also improved the median PFS of patients compared with placebo, which were 6.
5 months (95% CI 5.
6-7.
4) and 1.
9 months (95% CI 1.
9-2.
2) (HR 0.
42, 95% CI) 0.
32–0.
56); in ALBI level 2 patients, cabozantinib improved the median PFS of patients compared with placebo, which were 3.
7 months (95% CI 3.
5-4.
3) and 1.
9 months (95% CI 1.
8-1.
9) (HR 0.
46) , 95% CI 0.
37–0.
58)
.

Among ALBI grade 1 patients, cabozantinib also improved the median PFS of patients compared with placebo, which were 6.
5 months (95% CI 5.
6-7.
4) and 1.
9 months (95% CI 1.
9-2.
2) (HR 0.
42, 95% CI 0.
32–0.
56); in ALBI level 2 patients, cabozantinib improved the median PFS of patients compared with placebo, which were 3.
7 months (95% CI 3.
5-4.
3) and 1.
9 months (95% CI 1.
8-1.
9) (HR 0.
46) , 95% CI 0.
37–0.
58)
.

Among ALBI grade 1 patients, cabozantinib also improved the median PFS of patients compared with placebo, which were 6.

                      PFS

PFS

In both subgroups, the ORR of the cabozantinib group was 4%; in the ALBI level 1 subgroup, the ORR of the placebo group was 1%, and the ALBI level 2 subgroup was 0%
.

In the two subgroups, the disease control rate (DCR) of cabozantinib was also higher than that of placebo; for ALBI level 1, the DCR of the cabozantinib group was 74% and that of the placebo group was 40%; for ALBI level 2, the DCR was 57.

In both subgroups, the ORR of the cabozantinib group was 4%; in the ALBI level 1 subgroup, the ORR of the placebo group was 1%, and the ALBI level 2 subgroup was 0%

In the ALBI level 1 subgroup, 12% of patients in the cabozantinib group discontinued the study due to treatment-related adverse events (AEs), compared with only 2% in the placebo group

                   Adverse events

 Adverse events

In summary, the study shows that no matter ALBI level 1 or 2, cabozantinib is supported in the treatment of previously treated advanced hepatocellular carcinoma (HCC)
.

In summary, the study shows that no matter ALBI level 1 or 2, cabozantinib is supported in the treatment of previously treated advanced hepatocellular carcinoma (HCC)
.

The study shows that no matter ALBI level 1 or 2, cabozantinib is supported in the treatment of previously treated advanced hepatocellular carcinoma (HCC)

Original source:

Robin Kate Kelley, Rebecca Miksad, Irfan Cicin, et al.
Efficacy and safety of cabozantinib for patients with advanced hepatocellular carcinoma based on albumin-bilirubin grade.
British Journal of Cancer; https://doi.
org/10.
1038/s41416-021- 01532-5

Robin Kate Kelley, Rebecca Miksad, Irfan Cicin, et al.
Efficacy and safety of cabozantinib for patients with advanced hepatocellular carcinoma based on albumin-bilirubin grade.
British Journal of Cancer; https://doi.
org/10.
1038/s41416-021- 01532-5 Leave a message here